The TORCH complex is a set of perinatal infections that can be transmitted from mother to fetus, including toxoplasmosis, rubella, CMV, and herpes. These infections pose risks for severe fetal anomalies and can cause fetal death. Toxoplasmosis is caused by a parasite and transmitted through undercooked meat, soil, or water. Rubella virus causes congenital defects especially if the mother is infected in the first trimester. CMV and herpes viruses are also transplacentally transmitted and can cause issues like hearing loss, jaundice, or brain damage in the fetus or newborn. Diagnosis involves tests on maternal, amniotic, and neonatal samples. Treatment focuses on supportive
TORCH, which includes Toxoplasmosis, Other (syphilis, varicella-zoster, parvovirus B19), Rubella, Cytomegalovirus (CMV), and Herpes infections, are some of the most common infections associated with congenital anomalies.
TORCH, which includes Toxoplasmosis, Other (syphilis, varicella-zoster, parvovirus B19), Rubella, Cytomegalovirus (CMV), and Herpes infections, are some of the most common infections associated with congenital anomalies.
TORCH syndrome is a group of symptoms caused by Toxoplasmosis, Rubella, Cytomegalovirus, Herpes simplex, and other organisms including syphilis, Varicella zoster, and parvovirus.
This slide contains clinical features, perinatal and post natal diagnosis of congenital torch infection in fetus and neonates, and management of congenital toxaplasma, rubella, CMV, Herpes simplex, varicella, and other infections.
Rubella (German measles) is a disease caused by the rubella virus. Rubella is usually a mild illness. Most people who have had rubella or the vaccine are protected against the virus for the rest of their life. Because of routine vaccination against rubella since 1970 , rubella is now rarely reported.
TORCH syndrome is a group of symptoms caused by Toxoplasmosis, Rubella, Cytomegalovirus, Herpes simplex, and other organisms including syphilis, Varicella zoster, and parvovirus.
This slide contains clinical features, perinatal and post natal diagnosis of congenital torch infection in fetus and neonates, and management of congenital toxaplasma, rubella, CMV, Herpes simplex, varicella, and other infections.
Rubella (German measles) is a disease caused by the rubella virus. Rubella is usually a mild illness. Most people who have had rubella or the vaccine are protected against the virus for the rest of their life. Because of routine vaccination against rubella since 1970 , rubella is now rarely reported.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
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Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
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Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
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Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
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These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
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3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
2. TORCH complex is a medical acronym for a set
of perinatal infections .
TheTORCH infections can lead to severe fetal
anomalies or even fetal loss.
They are a group of viral, bacterial, and
protozoan infections that gain access to the
fetal blood stream transplacentally via the
chrionic villi.
Hematogenous transmission may occur at
anytime during gestation or occasionally at
the time of delivery via maternal-to-fetal
transfusion.
3. The capitalization"TORCH”consists of:
T–TOXOPLASMOSIS
O _Other infections (Syphilis,Varicella
Zoster, ParvovirusB- 19, HEP B)
R–RUBELLA
C–CYTOMEGALOVIRUS
H–HERPES SIMPLEXVIRUS–2
4.
5. Toxoplasmosis is a disease caused by an
intracellular parasite TOXOPLASMAGONDII.
Human acquisition of the infection occurs
by:
Oocyst contaminated soil,salads,vegetables.
Ingestion of raw or undercooked meat
containing tissue cysts (Sheep,pigs and
rabbits are the most common meat sources).
Out breaks of toxoplasmosis have also been
linked to the consumption of unfiltered water
6.
7. •Primary maternal infection in pregnancy–
Infection rate higher with infection in 3rd
trimester.
Fetal death higher with infection in 1st
trimester
8. Signs and sympoms
Infected Pregnant women : usually no clinical
manifestation.
Although some may have a mild
mononucleosis-like syndrome, regional
lymphadenopathy, or occasionally
chorioretinitis.
Similarly, infected neonates are usually
asymptomatic at birth.
9. Manifestations may include :
Prematurity
Intrauterine growth restriction
Jaundice
Hepatosplenomegaly
Myocarditis
Pneumonitis
Various rashes
anemia, thrombocytopenia,
and abnormal CSF findings (Mononuclear
CSF pleocytosis or elevatedCSF protein)
10. The classic triad of findings :
chorioretinitis,
hydrocephalus, and
intracranial calcifications
11.
12.
13. Diagnosis
Serial IgG measurement (for maternal
infection)
Amniotic fluid PCR (for fetal infection)
Serologic testing, brain imaging, CSF analysis
and ophthalmologic evaluation (for neonatal
infection),
and PCR testing of various body fluids or
tissues
14. Treatment
•In PREGNANT WOMEN with an established
recent infection, SPIRAMYCIN (3g daily in
divided doses) should be given.
In neonates :
Pyrimethamine: 50mg twice daily for 2 days
then 50mg daily.
PLUS
Sulfadiazine: 75mg/kg/daily in two divided doses
for 2 days then 50mg/kg/twice daily
PLUS
Folinic Acid: 10-20mg daily
16. It is caused by rubella virus,Rubivirus genus and
familyTogaviridae.
Intrauterine infection with rubella virus is referred
to as congenital rubella infection (CRI) or
syndrome.
Infection with rubella earlier in pregnancy(1st
trimester ) cause worse prognosis and neonatal
complications.
The virus can be transmitted to the fetus through
the placenta and is capable of causing serious
congenital defects, abortions, and stillbirths.
17. In the baby
Infection in weeks 8-10 of pregnancy results
in damage in up to 90% of surviving infants.
Multiple defects are then common.
The risk of damage reduces to 10-20% if the
infection is in weeks 11-16 of pregnancy.
Fetal damage is rare over 18 weeks of
gestation.
18. Transmission to the fetus occurs via maternal
hematogenous spread to the placenta.
It typically occurs 5-7 days after maternal
inoculation.
After the virus invades the placental barrier,
it spreads throughout the fetus via their
vascular system.
The congenital defects that result from
infection is secondary to the cytopathical
damage ensued to the blood vessels.
This in turn results in ischemia of the affected
organs .
20. Developmental:
Sensorineural deafness 80% .
General learning disability (55%).
Insulin-dependent diabetes (20%, immune-
mediated but often delayed to adolescence or
adulthood).
'Late-onset' disease at 3-12 months with rash,
diarrhoea, pneumonitis and high mortality.
21. Permanent:
Congenital heart disease (commonly patent
ductus arteriosus or peripheral pulmonary artery
stenosis).
Eye defects including cataracts, congenital
glaucoma, pigmentary retinopathy (50% - so-
called 'salt and pepper'), severe myopia,
microphthalmia.
Microcephaly.
22.
23. The risk of maternal-fetal transmission is the
greatest in the first 10 days after gestation
cardiac and eye defects typically resulting
when maternal infection occurs prior to 8
week.
Hearing loss is typically observed in
infections up to 18 weeks of gestation
24.
25. Lab tests :
Isolation of the rubella virus in culture
Demonstration of rubella-specific IgM
antibodies
Demonstration of rubella-specific IgG
antibodies that persist at a higher
concentration or longer duration than
expected from mere passive transfer of
maternal antibodies
Detection of rubella virus RNA by reverse-
transcriptase polymerase chain reaction
26. Treatment
Supportive care and surveillance is the only
recommended option available at this time.
Close monitoring within the first 6 to 12 months of
life is recommended; particularly for the evaluation
of hearing impairment .
Prevention is considered the most important aspect
as far as the management of CRI concerned.
Preventive measures include recommended
immunizations, testing of pregnant women for
rubella immunity and proper counseling regarding
avoiding exposure.
27.
28. CMV is a doubles stranded DNA herpes virus
The most common congenital viral infection.
The CMV seropositivity rate increases with age.
Geographic location, socioeconomic class, and work
exposure are other factors that influence the risk of
infection.
CMV infection requires intimate contact through
saliva,urine, and/ or other body fluids.
29. Possible routes of transmission include
sexual contact,
organ transplantation,
transplacental transmission,
transmission via breastmilk,and
blood transfusion(rare).
30. Primary,reactivation,or recurrent CMV infection
can occur in pregnancy and can lead to congenital
CMV infection.
Approximately 85 percent of newborns with
congenital CMV infection can be asymptomatic
at birth.
15 percent will develop progressive hearing loss
and visual impairment as they age.
32. Vertical transmission of CMV can occur at any
stage of pregnancy.
Severe sequelae are more common with
infection in the 1st trimester.
The overall risk of infection is greatest in
the 3rd trimester.
The risk of transmission to the fetus in
primary infection is 30%-40%.
38. Treatment
Ganciclovir 5mg/kg IV every 12 hours for 14
days
OR
Valganciclovir 900mg PO daily for 3-6
months
OR
CMV-specific hyperimmune globulin (200
units/kg of body weight)
39.
40. Herpes simplex virus (HSV) infection during
pregnancy can pose a serious threat to the
developing fetus and the newborn infant.
Transmission typically occurs via direct contact
between the neonate and an infected maternal
genital tract.
If the primary HSV infection was acquired during
pregnancy, then the risk of transmission is
greater as compared with reactivation of a
previous infection.
incidence of neonatal HSV infection ranges from
1 in 3200 to 1 in 10,000 births .
41. HSV is a member of the Herpes viridae family of
viruses
Enters the host through the inoculation of oral,
genital, or conjunctival mucosa.
Inoculation also can occur through breaks in the
skin.
Dissemination of the virus eventually allows the
virus to reach the dorsal root ganglia, where it
remains dormant for the rest of the host’s life.
Antiviral drugs do not affect latent HSV infection
and therefore infection is life-long
42. Intrauterine HSV is a rare occurrence and most likely
is caused by maternal viremia associated with
primary infection during pregnancy.
Intrauterine infection is associated with
hydropsfetalis and
in-utero fetal demise.
The characteristic triad noted at birth includes
skin lesions consistent of vesicles,
ulcerations or scarring ,
eye damage and
CNS abnormalities, such as hydranencephaly and
microcephaly.
43. Clinical manifestation can arise any time during
the first six weeks of life, but usually occurs
within the first month of life .
Classic CSF findings include :
a mononuclear cell pleocytosis,
normal or slightly low glucose concentration
and moderately elevated protein level.
Electroencephalogram (EEG) is often abnormal
from early on in the disease and may show focal
or multifocal periodic epileptic form discharges
. Neuroimaging studies may show parenchymal
brain edema, hemorrhage or destructive lesions
in the temporal frontal, parietal or brainstem
regions in the brain
44.
45.
46. Diagnosis
Diagnosis of neonatal HSV infection can be
established through any of the following
methods:
Isolation of HSV in culture
Detection of DNA via PCR assays
Detection of HSV specific antigens using
rapid direct immunofluorescence or enzyme
immunoassays.
47. Treatment
Suppressive viral therapy from 36 weeks
until delivery
Valacyclovir 500 mg orally BD OR
Acyclovir 400 mg orallyTDS.
Cesarean section is recommended for all
women in labor with active genital lesions
or prodromal symptoms such as vulvar pain
48. Others are :
Disease Trasmission Symptoms Diagnosis Treatment
Varicella zooster Ist 20 weeks of
pregnancy
Cicatricial
lesions ,limb
hypoplasia,micr
ocepaly ,hydrops
etc
Prenatal
Ultrasound
andMRI
Acyclovir
Parvo virus b19 1st 2 trimester of
pregnancy
ProdromalFever,
Slapped cheek
rash anemia etc
Serological
PCR
Symptomatic
relief
Syphilis
(Trepinoma
palidum )
Severe outcome
after 4 weeks
Miscarrage
,prematurity
,still birth,
hepatosplenome
galy,bullous
rash,pneumonia
Serological tests Benzathine
Penicillin G IM
Hep b transmission
specially in the
third trimester.
jaundice ,rashes
PAN ,Vomiting
,dark urine etc
Serological tests Lamivudine
,interferon alpha
entecavir